Особенности иммунного реагирования у пациентов с первичной открытоугольной глаукомой с использованием дренажных имплантатов

摘要

Purpose. To assess the presence and nature of local immune?status disturbances in the research of relative ratio of pro-inflammatory/anti-inflammatory cytokines in the lachrymal fluid?of primary open-angle glaucoma (POAG) patients, operated using?the method of microinvasive non-penetrating deep sclerectomy?with the Russian-made hydrogel implant and Healaflow?substance drainage (Anteis, Switzerland), taking into account?the presence and manifestation of risk factors for complications. Material and methods. The study included 74 patients (74?eyes) with primary open angle glaucoma. The lachrymal fluid sampling?was undertaken before and on the 1st and 7th day following?the operation. The above patients were divided into two main?groups based on the initial condition and surgical treatment forecast.?The data, obtained during the examination of 10 healthy volunteers?served as the contr ol. Results. The research found a significant increase in the?concentration of pro-inflammatory and anti-inflammatory IL1,?TNF α, IL6, IL8, IL10, IL1Ra, IL4, INF γ cytokines in the lachrymal?fluid of primary open angle glaucoma patients. Conclusion. The research showed an activation of immune?system manifested by an increased quantity of pro-inflammatory?and anti-inflammatory cytokines. The nature of their quantitative?indices and interaction thereof suggests a controlled process of?immune system activation with positive correlation towards anti-inflammatory cytokines in the favorable group and a deregulation?in the aggressive group as early as at the preoperative stage.?It should be noted that the study of the postoperative stage data?showed statistically significant IL1 β, IL6, IL4, IL10 quantitative?indicators in both groups that may be indicative of small invasion?and low traumatism of surgical intervention. However, the regulatory?component activation in the aggressive group remained above the indicators of the favorable group.